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Telehealth: benefits for primary care
Shahid Ali GP & National Clinical Lead Commissioning intelligence Clinical Lead Primary Care NHS Yorkshire and Humber
Telecoaching Telemonitoring TelemedicineTelehealth
Remote monitoring tools capture physiological measurements and relay them to a central location for review normally an suppliers intranet site.
Remote monitoring tools capture physiological measurements and relay them to a central location for review normally an suppliers intranet site.
Telecoaching uses a one to one interaction with audio, visual and/or interactive communications, used to support the practice of health care/social care, enabling self care and improved condition management.
Telecoaching uses a one to one interaction with audio, visual and/or interactive communications, used to support the practice of health care/social care, enabling self care and improved condition management.
Remote video consultations between healthcare professionals and patients which support care outside of hospital.
Used to reduce LOS, support early discharge, and admission avoidance.
Remote video consultations between healthcare professionals and patients which support care outside of hospital.
Used to reduce LOS, support early discharge, and admission avoidance.
The use of electronic information and telecommunications technologies to support long-distance clinical health care, professional health-related education, and public health.
The use of electronic information and telecommunications technologies to support long-distance clinical health care, professional health-related education, and public health.
Why use Telehealth? The Case for Change
Increasing numbers of people have multiple long-term conditions
•188% rise just in Diabetes by 2050•60% increase in multiple LTCs by 2013•252% rise in over 65 year olds by 2050
We currently spend £19 billion on people with 3+ long-term conditions. This is projected to rise to £26 billion by 2016
There is a need for a more integrated response to manage LTCs
Implications for NHS and General Practice
Long term conditions represent:•70% of health and care spend, •77% of inpatient bed days, •60% of GP appointments and•68% of outpatient and A&E appointments.
•The average annual health cost of someone without a long-term condition is around £1,000; this rises to £3,000 for someone with one condition and to £8,000 for people with three or more conditions
•The biggest challenge to emerging Clinical Commissioning Groups includes the management of LTCs and urgent care
Self care – fully independent
Signposted to information/advice
services
Advocacy &
support
Complexcases
LTC Population
Drivers for further change
Personalised health care- challenges current thinking of doctor-patient relationship
Proactive rather than reactive care –challenges current models of care delivery
Immediacy –challenges speed of care delivery
© NHS Yorkshire and the Humber
More than redesign ……..
Old Pathway New Pathway
Old Mindsets New Mindsets
Care Planning E-consultation Tele-health
Pre Post Pre Before Post After
Visits to GP x 23
Outpatients x 7
Outpatients x 1
Visits to GP x 7
Outpatient visits
Admissions Discharge
Tele-health package
Early discharge (monitored
and managed at home)
E-consultations
A new approach to care delivery……
Patient level impact of care planning
Data extrapolation to practice list sizes
Practice sizePre care planning (£000)
Post care planning (£000)
Difference (£000)
3,500 872.16 329.00 543.16 7,000 1,744.33 658.00 1,086.33 10,000 2,491.89 940.00 1,551.89
Care Planning E-consultation Tele-health
Pre Post Pre Before Post After
Visits to GP x 23
Outpatients x 7
Outpatients x 1
Visits to GP x 7
Outpatient visits
Admissions Discharge
Tele-health package
Early discharge (monitored
and managed at home)
E-consultations
Patient Centred Care: Immediacy
• A clinical opinion in a different way .... • Cohort of 16 GP practices / Nephrology (John Stoves, John Connolly et al,
Bradford)• E-consults for renal problems• Channelled to single consultant• Record reviewed / opinion written into e-notes• Need for face to face consultation reduced by 80%
Care Planning E-consultation Tele-health
Pre Post Pre Before Post After
Visits to GP x 23
Outpatients x 7
Outpatients x 1
Visits to GP x 7
Outpatient visits
Admissions Discharge
Tele-health package
Early discharge (monitored
and managed at home)
E-consultations
A world class solution……
• Bradford care home telemedicine pilot• Benefits
• Provides immediacy – patients can be assessed and treated sooner rather than waiting for a home visit.
• Electronic Patient Record (EPR) is available during the consultation so the GP can look at the record at the same time, and be better informed of the patient’s history, medication, hospital communications and any other important information that may be required during the consultation.
• Clinical triage- GP can assess the patient’s needs can give advice, prepare a prescription or indeed visit if needed.
• Increased efficiency- up to 80% of calls for home visits could be dealt with via telemedicine with only the minority still needing to be seen in person.
• Benefits
• Releases capacity -Time saving, cost saving, safer, manages risk more effectively, and is a simple way of conducting consultations. Improved efficiency releases capacity in the Practice which is important as complexity and demand increases in primary care.
• Reduced admissions- the quicker you get to see a patient the easier it is to address their need. If you don’t get a clinical opinion early enough, the patient is more likely to end up in A&E or be admitted.
• Patients satisfaction high – patients and care home staff like it - they can see and speak to the doctor and get seen quickly.
• Simple to use and there is no training needed.
Regional T-health Programme - Role of the “Hub”
Distributed specialist networks
Top Tip: “Don’t be afraid of new technology and don’t assume it’s difficult or complicated to useuntil you’ve tried it. It really is so simple, so do it!”
Contact details:[email protected]@bradford.nhs.uk